Dermal substitutes are of major importance in treating full thickness skin defects, both in acute and chronic wounds. In this review we will outline specific requirements of three classes of dermal substitutes: Biological and clinical requirements will be translated to composition, physical structure, immunological properties and cell-matrix interactions of the various materials. Important properties like pore size, cell adhesion sites (e.g. RGD sequences), crosslinking, degradability and the presence of a basement membrane will be discussed for each of the different classes of materials. Copyright 2009 Elsevier Ltd and ISBI. All rights reserved.